Chapter 948: 928 Hepatolenticular Degeneration?

928 Hepatolenticular Degeneration?

Director Zhou didn't think Zheng Ren was making a fuss over nothing.

With Director Kong's 912 connection, Zheng Lao Ban definitely wouldn't come for no reason to slap Zhu Liangchen's face. If I were ten years younger, high‑spirited and arrogant, jumping out, I might possibly be hit hard.

Moreover, the patients just now were all fine, those who should go up have gone up, but why is there something now?

Looking at Zhu Liangchen's appearance, he probably shares my view, thinking there's nothing wrong.

Strange.

Soon, Zheng Ren and Zhu Liangchen walked back.

"Teacher Zhu, I suggest postponing this surgery," Zheng Ren said. "I looked at the head images and have some doubts. I want to run a few more tests, confirm the diagnosis, then do the surgery."

"Boss Zheng, what disease do you think it is?" Zhu Liangchen became a little unhappy.

Denying the diagnosis? That's a classic face‑slapping pose.

Among doctors, mutual hostility; the deadliest attack is——he can also see patients?

Zhu Liangchen stared at Zheng Ren, his expression growing colder.

"The patient's head CT shows bilateral low‑density symmetrical lesions in the lenticular nuclei. This image is faint, easy to overlook; the CT side thinks it's an artifact." Zheng Ren inserted the head CT film into the viewer.

He pointed at the CT film and said: "Head MRI is more specific than CT, showing low signal on T1‑weighted and high signal on T2‑weighted images in the lenticular nucleus, caudate nucleus, midbrain, pons, thalamus, cerebellum, and frontal‑cortical cortex, or mixed high‑low signal on T2‑weighted images in the putamen and caudate nucleus, possibly with varying degrees of widened cerebral sulci and enlarged ventricles."

After saying that, Zheng Ren continued: "I think the patient has comorbid hepatolenticular degeneration, a rare condition. I recommend checking copper‑metabolism related biochemical tests: serum ceruloplasmin, urinary copper, hepatic copper."

These tests are rather obscure. In a place like Hai Cheng, they basically don't exist; even if you heard of them, you might not have.

But the Di Du Liver‑and‑Gallbladder Hospital is a specialty hospital; these tests should be available.

Hepatolenticular degeneration?

Zhu Liangchen and Director Zhou both froze for a moment, then began recalling this extremely rare disease.

This disease results from excess free copper in the serum depositing heavily in the liver, causing lobular cirrhosis.

When liver cells' lysosomes can't hold it, copper spreads via the blood to various organs and deposits. Neurons in the basal ganglia and their normal enzyme transport are especially sensitive to inorganic copper's toxicity, and copper deposition in the cerebral cortex and cerebellar dentate nucleus also produces symptoms.

Copper's damage to the renal proximal tubules can cause loss of amino acids, protein, calcium, and phosphate; moreover, deposited free copper in the corneal elastic layer produces a K‑F ring.

At the same time, cirrhosis can produce a series of changes due to portal venous hypertension.

If the diagnosis were hepatolenticular degeneration…… Director Zhou's face showed a hint of a smile.

Things are getting more interesting.

Zhu Liangchen's luck isn't great. This disease occurs in about one in a hundred thousand.

Besides, we have to get it from his hands, then look for Boss Zheng to do the surgery.

Tsk tsk, this luck—unmatched.

Zhu Liangchen felt a bit embarrassed; his face drooped.

This is being stopped by the "Professor"…… Before, only I stopped others' surgeries; who has ever stopped their own!

"The patient's expression is odd, speech slurred, muscles spasming, yet not the rhythmic spasms of Parkinson's." Zheng Ren ignored Zhu Liangchen's displeasure and spoke frankly: "Let's stop this surgery, first get a clear diagnosis. If the diagnosis is correct, give the patient a course of D‑penicillamine; once symptoms ease, we can do the surgery anytime."

Su Yun frowned on the side.

Running flying knives in Di Du—whether we make money or not aside—every step must be taken with great caution.

They're big shots in the industry; even if their skill is a bit lacking, you can't resist their wide network. Doing flying knives in other cities is a completely different concept.

Having slighted Zhu Liangchen's face, how will Director Kong view it?

But what Zheng Ren said isn't wrong either; if it truly is hepatolenticular degeneration, doing a TIPS surgery directly would cause problems with the patient's copper metabolism.

Sigh, really unlucky to run into this situation.

Zhu Liangchen stayed silent for a few seconds, then nodded and said, "Then let's stop this patient's surgery."

The office air instantly felt a bit lighter.

The remaining two patients quickly finished reviewing their films; Zhu Liangchen, face grim, arranged for someone to talk with the patients' families, then brought Zheng Ren up for surgery.

The atmosphere wasn't as harmonious as when we first arrived.

Su Yun wanted to pull Zheng Ren aside to ask about the situation, but Zhu Liangchen was always at his side, so she never got a chance.

Arriving at the operating room, Hu Yan Hui had already prepared the equipment for the surgery live broadcast, waiting for the live surgery.

The order of this surgery didn't consider the live broadcast; it was arranged by patient age.

Because the surgery requires fasting, the older patients go first—a point Zheng Ren also agrees with.

After changing into lead clothing and starting to scrub, Su Yun finally got a chance, grabbed Zheng Ren and asked, "Boss, is the diagnosis of hepatolenticular degeneration definite?"

"Huh?" Zheng Ren blinked, then laughed: "Definite. It's not to save Teacher Zhu's face—if the patient underwent surgery, venous blood wouldn't pass through the liver, losing its toxin filtration, making acute copper‑poisoning symptoms very likely."

Su Yun nodded; as long as it's confirmed, there's nothing more to say.

Out of consideration for Zhu Liangchen's face, the one who ended up getting slapped was still Zheng Ren. He just didn't understand, and asked softly, "Have you ever seen a patient with hepatolenticular degeneration?"

"No."

"Then how did you diagnose it?" Su Yun asked.

Normally, the directors in Di Du see a hundred‑eighty patients a day, with plenty of tough cases. If we compare talent, Zheng Ren might be stronger than anyone; but if we compare experience points, he might be a bit weaker.

This is also something Su Yun has been worried about.

But… today's events made him feel that his worldview was once again forcibly twisted by Zheng Ren into another direction.

"Reading books—shouldn't we just note down every liver lesion and compare them one by one?" Zheng Ren also expressed surprise to Su Yun: "You don't examine patients like that, do you?"

"……" Su Yun really wanted to go beat up Zheng Ren.

Regarding liver lesions, there aren't a thousand, but there are eight hundred. Who could remember them all without missing any? And you have to go through them for every patient you see?

This guy—really not human at all.

"I'm on stage—where is the live‑broadcast surgery scheduled?"

"The third and sixth." Su Yun said expressionlessly.

"Oh, contact Director Kong, see when Director Kong and Professor Pei can arrive." Zheng Ren said.

"You're still afraid that even after you finish, they won't be able to arrive?" Su Yun was already getting impatient.

"Yeah." Zheng Ren said frankly.